Disorders Matrix and Other Final Info Flashcards
flaccid dysarthria: etiologies
- ALS
- myasthenia gravis
flaccid dysarthria: site of lesion
lower motor neuron (LMN)
- final common pathway
- motor unit
flaccid dysarthria: type of damage
- posterior fossa
- peripheral axon
- myoneural junction
flaccid dysarthria: characteristics
- weakness
- reflexive, automatic, and voluntary movements
- atrophy
flaccid dysarthria: oral mech and motor speech results
problems with executing the movement
flaccid dysarthria: characteristics of respiration
- mono loudness
- speaking on inhalation
flaccid dysarthria: characteristics of phonation
- breathiness
- stridor
- diplophonia
flaccid dysarthria: characteristics of articulation
weak/slurred
flaccid dysarthria: characteristics of resonance
hypernasality
flaccid dysarthria: treatment
- strength: isotonic/isometric exercises
- effortful closure technique
spastic dysarthria: etiologies
ALS, CP, MS
spastic dysarthria: site of lesion
upper motor neuron (UMN)
- direct and indirect activation pathways (pyramidal and extrapyramidal)
spastic dysarthria: type of damage
- pyramidal
- extrapyramidal
- supratentorial
- posterior fossa
spastic dysarthria: other notable characteristics
- spasticity
- decreased reflexes initially, then more pronounced
- Babinski sign
- Pseudobulbar affect
spastic dysarthria: oral mech and motor speech results
- slow and regular AMRs
- articulation errors, but decent prosody (general dysarthria)
spastic dysarthria: characteristics of respiration
- mono loudness
- intermittent breathy/aphonic segments
spastic dysarthria: characteristics of phonation
- strained
- harshness
- pitch breaks
spastic dysarthria: characteristics of articulation
- slow and effortful
- imprecise, long phoneme duration
spastic dysarthria: characteristics of resonance
hypernasality
spastic dysarthria: treatment
- sustained phonation with visual feedback
- reduced rate techniques
ataxic dysarthria: etiologies
AT, MS, Friedrich’s ataxia
ataxic dysarthria: site of lesion
cerebellum
- cerebellar control circuit
ataxic dysarthria: type of severity
posterior fossa
ataxic dysarthria: characteristics
- incoordination
- reflexive swallow
- gag
ataxic dysarthria: oral mech and motor speech results
- irregular and slow AMRs
- movement is uncoordinated
ataxic dysarthria: characteristics of phonation
- loudness variations
- coarse voice tremors
ataxic dysarthria: characteristics of articulation
- slow rate
- prolonged phonemes
ataxic dysarthria: treatment
- contrastive production
- intelligibility drills
hypokinetic dysarthria: etiologies
Parkinson’s disease
hypokinetic dysarthria: site of lesion
basal ganglia control circuit (extrapyramidal)
hypokinetic dysarthria: type of damage
supratentorial
hypokinetic dysarthria: other notable characteristics
- rigidity, reduced range of movement
- involuntary movement
- Bradykinesia or Akinesia
hypokinetic dysarthria: oral mech and motor speech results
- rapid, “blurred” AMRs
- issues with control
hypokinetic dysarthria: characteristics of respiration
- breathiness
- mono loudness
hypokinetic dysarthria: characteristics of phonation
mono pitch
hypokinetic dysarthria: characteristics of articulation
- reduced stress
- inappropriate silences
hypokinetic dysarthria: characteristics of resonance
hypernasality
hypokinetic dysarthria: treatment
- levodopa (pharmalogical treatment)
- daily speech program
hyperkinetic dysarthria: etiologies
Huntington’s disease
hyperkinetic dysarthria: site of lesion
basal ganglia control circuit (extrapyramidal)
hyperkinetic dysarthria: type of damage
supratentorial
hyperkinetic dysarthria: characteristics
involuntary movements
hyperkinetic dysarthria: oral mech and motor speech results
slow and regular AMRs
hyperkinetic dysarthria: characteristics of respiration
- audible inspiration
- sudden forced inspiration/expiration
hyperkinetic dysarthria: characteristics of phonation
- strained harshness
- voice stoppages
hyperkinetic dysarthria: characteristics of articulation
- reduced stress
- increased rate in segments
hyperkinetic dysarthria: characteristics of resonance
hypernasality
hyperkinetic dysarthria: treatment
- controlled exhalation
- postural adjustments (upright for inspiration, supine for expiration)
- optimal breath groups
- Accent Method of Voice Therapy
unilateral UMN: etiologies
- stroke
- neurosurgery
unilateral UMN: characteristics
- weakness
- incoordination
- spasticity
unilateral UMN: site of lesion
upper motor neuron
- direct and indirect pathways (pyramidal and extrapyramidal)
unilateral UMN: oral mech and motor speech results
- irregular AMRs
- velar implications
unilateral UMN: characteristics of phonation
- slow rate
- mono loudness
unilateral UMN: characteristics of articulation
imprecise, irregular articulatory breakdowns
unilateral UMN: treatment
- expiratory muscle strength training
- phonetic placement
mixed dysarthria: etiologies for flaccid-spastic
ALS
mixed dysarthria: etiologies for spastic-ataxic
MS
mixed dysarthria: degenerative etiologies
ALS, MS, PSP
mixed dysarthria: toxic metabolic etiologies
Wilson’s disease, Hepatocerebral degeneration, Hypoxic encephalopathy
mixed dysarthria: site of lesion
- cerebellum/cerebellar connections
- UMN
- LMN
mixed dysarthria: treatment
- adjusting posture for breath support
- visual feedback for articulation
- emphasizing differences between similar phonemes
- pacing strategies
- group phrasing
acquired apraxia of speech (AOS): etiologies
- stroke
- Broca’s aphasia
acquired apraxia of speech (AOS): site of lesion
left (dominant) hemisphere
acquired apraxia of speech (AOS): oral mech and motor speech results
- rapid, “blurred” AMRs
- poorly sequenced SMRs
acquired apraxia of speech (AOS): characteristics of phonation
- mono pitch
- mono loudness
acquired apraxia of speech (AOS): characteristics of articulation
- marked deterioration with increased rate
- articulatory groping
acquired apraxia of speech (AOS): treatment
- articulatory-kinematic
- melodic intonation therapy (MIT)
- script training
- sensory cueing
A 55-year-old right-handed man was admitted to the hospital with a 4-day history of progressive right hemiparesis and dysarthria. Neurologic evaluation revealed dysarthria, right hemiparesis, and mild sensory loss in the right face and upper limb. A CT scan showed evidence of an infarct in the posterior limb of the left capsule. Speech evaluation 2 1/2 weeks after onset revealed a right central facial weakness. Speech was characterized by imprecise articulation, harsh voice quality, and slow speech AMRs. Intelligibility was moderately reduced. There was no evidence of aphasia or cognitive disturbance.
unilateral upper motor neuron (UUMN) dysarthria
A 29-year-old woman presented to a rehabilitation unit 14 months after cerebral anoxia that developed secondary to cardiac arrest during a tubal ligation. Neurologic exam revealed neck and left upper extremity rigidity, and weakness in all extremities. Gait was slow with short steps. She had difficulty with chewing and swallowing and frequently choked on solid foods. Speech evaluation revealed reduced loudness, imprecise articulation, accelerated speech rate, little variation in pitch, loudness and syllable duration, and reduced range of articulatory movement. Speech AMRs were “super fast and blurred.”
hypokinetic dysarthria
A 63-year-old woman was hospitalized for evaluation/treatment of cardiovascular problems. She had a h/o myocardial infarction and had coronary bypass surgery 6 mo. previously. Three weeks before admission, she developed sudden onset of speech difficulty and problems with gait. She had no difficulties with language, chewing, or swallowing. Oral mechanism exam was normal. Speech was characterized by irregular articulatory breakdowns, irregular speech AMRs, and unsteady vowel prolongation; intelligibility was normal.
ataxic dysarthria
